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Organization

LIFE SKILL REHAB, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KYNDA RAY M.S. CCC/SLP (PRESIDENT/OWNER)
(618) 599-0743
Entity
Organization

Contact information

Practice address
636 N LAKE BLVD, TARPON SPRINGS, FL 34689-5247
(618) 599-0743
Mailing address
636 N LAKE BLVD, TARPON SPRINGS, FL 34689-5247
(618) 599-0743

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1851439467
NPI
Enumeration date
01/05/2019
Last updated
01/13/2019
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